Hair loss

Tim Jackson

Most forms of chemotherapy, especially Cyclophosphamide and Taxanes, (but not Herceptin) cause hair loss. As well as head hair you may lose other body hair and fingernails, especially with taxanes.

This is because chemotherapy attacks all rapidly dividing cells in the body which, as well as cancer cells, means hair and fingernails, blood cells, and any wound healing process. The principle is that the body can manage without any cell division for quite a while, but the cancer cannot.

Exactly how your hair falls out and grows back is a personal thing, but generally you can expect it to become very loose and start falling out in clumps about two weeks after you start chemo. It is a good idea to cut it very short or shave it off before this happens, it is less distressing and less lilkely to block the shower drain if you have less to lose.

Your hair continues to grow (and fall out) between chemo sessions, and many people find that they have a few millimetres of short 'peach fuzz' throughout the process.

Once you have finished chemo it will take about three months to get enough hair to cut. It will probably start off rather thin, straggly and patchy, and it may be surprisingly different. Often it starts out growing curly. If you had some gray hair, you may find that the more strongly coloured hair grows back first, making it initially darker, or you may find that it all grows back gray. This is because many of the hair follicles are damaged or blocked and they recover progressively, first growing a distorted curly hair which straightens out as the follicle recovers. As time progresses more and more follicles come back 'on stream', and the hairs become less distorted and straighter until after a year or so it is more or less back to normal.